Organization
ELITE THERAPEUTICS AND HEALTHCARE, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NATHANIEL B VIZCAYNO (PRESIDENT)
(847) 409-6643
Entity
Organization
Contact information
Practice address
536 W DAYBREAK LN, ROUND LAKE, IL 60073-5696
(847) 409-6643
(224) 338-0515
Mailing address
536 W DAYBREAK LN, ROUND LAKE, IL 60073-5696
(847) 409-6643
(224) 338-0515
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
070011571
IL
Other
Enumeration date
01/12/2009
Last updated
01/12/2009
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